Disclosure, Social Support, and Mental Health are Modifiable Factors Affecting Engagement in Care of Perinatally-HIV Infected Adolescents: A Qualitative Dyadic Analysis.

Journal: AIDS and behavior

Volume: 25

Issue: 1

Year of Publication: 2021

Affiliated Institutions:  Emory University School of Medicine, Uppergate Drive, Atlanta, GA, , USA. bzanoni@emory.edu. University of KwaZulu-Natal Nelson Mandela School of Medicine, Durban, South Africa. Mahatma Gandhi Hospital, KwaMashu, South Africa. Massachusetts General Hospital, Boston, MA, USA.

Abstract summary 

Adolescents living with perinatally acquired HIV in South Africa face significant barriers to successful transition from pediatric to adult care. We performed in-depth qualitative interviews with 41 adolescents living with HIV and 18 of their caregivers to investigate modifiable factors to improve engagement in care prior to transition to adult care. Based on dyadic, inductive content analysis, findings suggest that HIV status disclosure, social support, and mental health are targets for improvement in engagement in care. Early disclosure and a sense of belonging facilitated engagement in care, while barriers included delayed or inadequate disclosure, denial, and lack of disclosure to others. Adherence support improved by having a biological mother as a direct supervisor. Barriers to care included changing caregivers, abandonment, undiagnosed mental health problems and learning difficulties. Despite these factors, the majority of adolescents showed resilience and remained engaged in care despite difficult circumstances.

Authors & Co-authors:  Zanoni Brian C BC Archary Moherndran M Subramony Tamarra T Sibaya Thobekile T Psaros Christina C Haberer Jessica E JE

Study Outcome 

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Citations :  Life expectancy of individuals on combination antiretroviral therapy in high-income countries: a collaborative analysis of 14 cohort studies. Lancet. 2008;372(9635):293–9.
Authors :  6
Identifiers
Doi : 10.1007/s10461-020-02968-1
SSN : 1573-3254
Study Population
Male,Female
Mesh Terms
Adolescent
Other Terms
Adolescent;Engagement in care;HIV;South Africa;Transition
Study Design
Cross Sectional Study
Study Approach
Qualitative
Country of Study
South Africa
Publication Country
United States